Sarcouncil Journal of Medical Series

Abstract: The current study aimed at explaining the relationship between the body mass index (BMI), endometrial thickness (ET), and histopathological outcomes in postmenopausal women with genitourinary bleeding. The study was implemented as a multicentric study and involved 84 Iraqi participants; transvaginal ultrasonography was used to measure the ET, and biopsy samples of the endometriums were excised to be followed by further histopathological review. The results showed that there is a statistically significant positive correlation between BMI and ET, with obese persons showing increased endometrial thickness and a higher prevalence of endometrial hyperplasia and carcinoma. The incidence of endometrial carcinoma was significantly high among obese respondents compared to the normal BMI cohort. The ET threshold of 4 mm was supported as one of the effective clinical demarcations, and any measurement that exceeded it was correlated with the clinically significant pathology that required to undergo additional diagnostic study. Such data underscore the importance of the combination of BMI and ET assessments into the diagnostic algorithm of postmenopausal bleeding, hence supplementing the identification of endometrial pathology and the therapeutic decision-making. This kind of approach perfects risk stratification, particularly in obese patients, which encourages the timely detection and treatment of malignant conditions.